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NPI Code Detail

MEDICARE: FAYE ALLEYNE ARCHER MS ED

MEDICARE: FAYE ALLEYNE ARCHER MS ED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor825720NY

General Provider Information

NPI Number : 1467215061
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAYE ALLEYNE ARCHER MS ED
Provider Business Mailing Address
First Line : 1217 E 94TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3930
Country : US
Telephone Number : 347-277-9979
Fax Number :
Provider Business Practice Location Address
First Line : 2148 OCEAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1483
Country : US
Telephone Number : 718-375-2505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 02/05/2024

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